Telemedicine as a means to monitoring physical activity in adolescents with cystic fibrosis.
Telemedicine as a means to monitoring physical activity in adolescents with cystic fibrosis.
Introduction
Among the new technologies used to encourage self-management and self-care, telemedicine (TM) can be used in cystic fibrosis (CF) for the supervision and promotion of physical activity. The aim of the study is to evaluate the amount of physical activity over time in a group of adolescents with CF (awCF) enrolled in a telemedicine pilot project.
Methods
The TM program was proposed to all awCF aged 14-18 years followed by the pediatric CF center in Milan, who were clinically stable at the time of enrollment. Physical activity was monitored using a fitness tracker watch provided to each participant; each week, awCF were asked to send an e-mail with the automatic watch report to the dedicated team of physiotherapists. Mixed-effect models were used to analyze longitudinal data.
Results
TM was proposed to 40 adolescents out of the 68 in regular follow-up (58.8%), aged 15.9 (0.2) years. Adherence to the project was 77.5% (31/40). 20/31 (64,5%) of the enrolled adolescents (15 females) submitted physical activity data: baseline number of steps was 43093 (95%CI:30282;55905). Over weeks, steps decreased by 62.3 (95% CI: -220.2; 93.9). 48 weeks after the start of the project, adolescents walked 5670 (95%IC: -85434; 74094) fewer steps. Minutes in the active zone averaged 85.6 (95%IC: 65.7; 106) per week, with a negative trend (-0.48, 95%IC; -1.04; 0.08 min) over time. On average, awCF had a forced expiratory volume in the first second (FEV1) of 96.6 (3.0)%. Lung function during the 48 weeks observation period remained stable in both enrolled and non-enrolled adolescents (-1.8, 95%IC: -15.7; 12.1 %).
Discussion and Conclusion
Telemedicine can be considered a useful means in the context of a chronic condition such as CF to increase self-management. Mostly well received, TM can assist physiotherapists to assess physical activity levels remotely, modifying the amount of physical activity when necessary to reach recommended levels. Longitudinal studies are needed to assess the impact of long-term telemedicine on adherence and health care costs.
REFERENCES
Standards of Care and Good Clinical Practice for the Physiotherapy Management of Cystic Fibrosis (2020).